Scientists in Newcastle can now produce early stage human sperm cells from stem cells in the laboratory. This research is important for furthering our understanding of human development. If human eggs could be produced using similar methods in future, then this could potentially allow babies to be created without the need for testes or ovaries. Such innovation might have profound consequences for infertility treatment, sperm/egg donation and reproductive autonomy.

This week's Daily Mail questioned whether the prospect of being able 'to conceive babies with sperm and eggs made from one person's tissue' would lead to what has apparently been branded the 'ultimate incest' - children effectively born with the same mother and father. But what's the real story behind this unlikely tale? This was a theme of a very timely debate - 'Artificial Gametes: The What, Why and How of Creating Sperm and Eggs in the Lab,' - organised by Progress Educational Trust at the Newcastle Centre for Life on 12 February.

The proceedings were reported in a recent BioNews commentary by Alison Murdoch, who also chaired the debate (1). This article highlights some of the views represented by a lively audience of some 105 attendees - an eclectic mix of policy makers, journalists, patients, academics, clinicians, students and lay publics.

Murdoch, Professor and Head of Reproductive Medicine at Newcastle University, was pleased to welcome two speakers: John Burn, a scientist involved in work on artificial gametes at Newcastle University, and Dr Donald Bruce, a medical ethicist with extensive experience in stem cells. A third speaker Anna Smajdor, Lecturer in Medical Ethics at the University of East Anglia, was unable to make the event due to severe travel problems. Nonetheless, her unique perspective is summarised in another recent BioNews commentary (2).

Murdoch opened the debate with an explanation of the rudiments of reproduction and stem cell science, aimed at helping the full range of audience participants to join the debate on a relatively even level of understanding. In his talk, Professor Burn went into the work on artificial gametes in further detail, putting emphasis on safety issues and the danger that prohibitive legislation might risk denying future patients access to treatment from which they could potentially benefit. Finally, Dr Bruce outlined some of the ethical questions raised by artificial gametes, in particular exploring the moral status of the embryo and whether creating a technology that allows us to do away with either one sex or the other, 'risks something important about our most intimate parts of humanity'.

Following the talks a lively debate ensued with audience comments, ranging from those interested in championing the work, to those much more sceptical about its ethics and likely success.

A common theme throughout was the relationship between different stakeholders, including scientists, media, government, and the public. One audience member felt that some scientists encourage media sensationalism in an effort to get publicity and attract funding for their work. Burn agreed that it was easy for scientists to get drawn in to making speculations that make big headlines, but that neither scientists nor the media were entirely to blame for this. Others felt that enthusiasm over scientific breakthroughs was legitimised and necessary for generating meaningful debate. In conclusion, Burn drew attention to the need for the scientific community to keep open and honest lines of communication with the public regarding the ethical dimension of this work.

Other questions from the floor related to the moral status of the embryo, with one audience participant asking 'What use are sex cells if all our cells have this status?' Burn's perspective was that, since in his opinion there is a difference between a fertilised cell and a 70 year old person, the value of the lives of those being treated outweighs that of any embryos which may be destroyed. Bruce added that the worth of an embryo is not really to do with its size, stating his view that the moral question lies in how the embryo is obtained - those which would be destroyed anyway are more ethically justified than those which are created purposefully.

Burn's emphasis on safety was broadly welcomed by audience participants. In response, to questions concerning the implications of something 'going wrong', Murdoch highlighted that all proposed regulatory frameworks take safety into account and that even the most liberal approach requires clinics to make a licence application to the HFEA (Human Fertilisation and Embryology Authority), backed up by extensive risk and ethical assessments. Bruce highlighted the need for both ethical and safety issues to be jointly considered in all cases.

One audience member questioned the use of the word 'artificial', arguing that by implication an artificial gamete should be as viable as a naturally produced one. In response Burn usefully proposed that artificial gametes be renamed 'cultured gametes' on the basis that they are not entirely synthetic but rather derived from the redirection of natural processes.

One final issue was the possibility that umbilical cord cells might provide more ethical source of stem cells for artificial gametes, however it was noted that a prerequisite for this is that there needs to be a good mechanism in place for banking cord blood. Burn speculated that it was important to support research into stem cells derived from a variety of sources, but that gametes derived from embryonic stem cells were the 'gold standard' to which all other forms should be compared.

Murdoch closed the debate by taking a vote on which of three different approaches to regulating artificial gametes audience members preferred. While five people were in favour of an outright ban and 35 voted to keep the system of HFEA regulation currently in place, the majority of voters preferred the middle ground, whereby Parliament is allowed to reconsider the current ban on using artificial gametes in fertility treatment at any time.

While the majority vote was for a more progressive approach to the regulation of artificial gametes, several audience participants voiced concerns that these views may not be representative of society, with one person emphasising that lay publics need adequate opportunities to engage with the issues before being able to make a valuable contribution to the debate.

The event provided a welcome opportunity for a wide-ranging public debate on a scientific development that raises important ethical issues. Progress Educational Trust's next debate, 'Debating deafness and embryo selection: are we undermining reproductive confidence in the deaf community?' will be held in Cardiff on Wednesday 9 April - see 'Recommends' for how to book a place at what promises to be another extremely lively - and timely event.

SOURCES & REFERENCES

1) 'Artificial Gametes: The What, Why and How of creating sperm and eggs in the laboratory' Commentary by Alison Murdoch, BioNews, 26th February 2008.

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2) 'Artificial gametes: the end of infertility?' Commentary by Anna Smadjor, BioNews, 26th February 2008.

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